How Insomnia Could Accidentally Kill You

We talk a lot about the dangers of poor sleep. It can impact health risks, mental and physical well-being, performance and quality of life. But one other serious consequence of poor sleep that’s often overlooked is accidental death.

A recent study emphasized that danger for unintended fatal injury. Researchers in Norway undertook a large-scale evaluation of the relationship between symptoms of insomnia and the risk of fatal accidental injury. Their study included 54,399 men and women between 20 and 89. Researchers collected data over a 14-year period about the presence of insomnia symptoms including problems falling asleep, trouble staying asleep and experiencing poor quality sleep.

To identify possible links between insomnia and accidental fatal injuries, the authors compared their survey data to data obtained from Norway’s National Cause of Death Registry. Over the 14-year study period, there were 277 accidental fatal injuries. Of those deaths, 57 were due to fatal car accidents.

Their analysis showed that insomnia was an important factor in the risk of an accidental fatal injury, which included both car accidents and other injuries like falls or drowning. As insomnia symptoms increased, so did the risk for both fatal injury and fatal motor vehicle accidents. From this, the researchers could figure out the percentage of fatal accidents that might have been prevented if the population was well rested.

Among motor vehicle deaths, the effect of getting good quality sleep was dramatic:

One-third of deaths could have been prevented if people didn’t have trouble falling asleep.

One in 10 deaths could have been prevented if people didn’t have trouble staying asleep.

One in 10 deaths could have been prevented if people slept well overall.

We then have to ask how the symptoms of insomnia play this dramatic role in increasing accident risk. Another new study points to some answers. Researchers examined cognitive impairment in people with insomnia and found lack of sleep led to problems with attention and episodic memory. Episodic memory is made up of memories of individual events and details like place, time and emotion. Diminished attention almost certainly plays a role in accidental fatalities, and it is entirely possible that compromised episodic memory could play a role as well.

With nearly a third or more of adults estimated to experience insomnia symptoms, the danger that these sleep problems pose are widespread and significant. Diagnosing and treating insomnia is critically important to your health and your safety. Fortunately, we’ve seen tremendous progress in the treatment of insomnia, both in pharmacological and non-pharmacological therapies.

Pharmacological therapies include new drugs that work as an entirely new type of sleep medication, by blocking the brain receptor for a hormone called orexin that promotes wakefulness and alertness. Unlike other sleep medications that play with the brain’s “sleep” switch, this new form of medication changes the brain’s “wake-up” switch.

Other important therapies, like cognitive behavioral therapy (CBT), exist to help reduce or eliminate the difficult symptoms of insomnia. CBT has been shown tremendously effective in reducing the symptoms of insomnia and works by changing behaviors, attitudes and feelings about sleep. In a series of structured sessions with a therapist or counselor, patients reflect on how things they think or do could mess with their sleep. They then work to replace those behaviors with habits that promote good sleep.

This works because feelings that disrupt sleep like frustration, anxiety and fear can fade away with the right training. I use CBT in my practice on a regular basis with my patients and it has proven tremendously successful in helping insomnia. Here are some specific behavior changes often used in CBT sleep therapy that can reduce frustration and improve sleep.

Sleep restriction. Limit your time in bed to the actual time spent sleeping. Gradually increase this time until it is in the healthy seven to eight hour range. Sleep restriction helps to avoid the frustrating and anxiety-producing routine of lying in bed trying to fall asleep.

Sleep hygiene education. Sleep is deeply affected by lifestyle factors, including diet, exercise, substance use and sleep environment. Knowing which factors might be affecting your sleep and learning how to adjust them can make a big difference to sleep quality.

Cognitive restructuring. You may have a certain set of ideas or attitudes about your sleep. An example might be thinking you’ve always had insomnia and that it’s just not possible for you to get a good night’s sleep. Cognitive restructuring allows you to review these attitudes and beliefs and work to re-frame those thoughts in more positive ways.

Meditation and relaxation training. Specialized relaxation techniques can provide relief for anxiety and help make falling asleep and staying asleep easier.

The most important thing you can do if you’re experiencing trouble sleeping or symptoms of insomnia is to seek help. Getting the right treatment can help you sleep better and keep you safe.